OrthoWertz
Ken Wertzberger, M.D.
Shane Alford, P.A.
ARTHROSCOPIC SURGERY INFORMATION
SHEET
Arthroscopic surgery is a technique in the field of orthopaedic surgery which allows orthopaedic
surgeons to utilize modern optical and surgical instruments in the diagnosis and repair of damage inside of
human joints. The word "arthroscopy" is derived from the Greek words "arthros" (joint) and "scopes" (to look).
Arthroscopic procedures are usually outpatient, less uncomfortable, and more cosmetic than a similar
procedure done by traditional open surgery in years gone by.
Currently, the most common operation in arthroscopy still tends to be that of removal of a piece of
cartilage, or meniscus, in the knee, which is catching or causing pain in the joint. Arthroscopy has expanded
greatly since its inception. Most operations are done with the aid of the arthroscope. Most joints can be
arthroscoped now, with variable results. In any operation that involves healing instead of removal( i.e.
meniscus removal versus ACL reconstruction or rotator cuff repair) the recovery period is the same, even
though done through small puncture wounds by virtue of the arthroscope. This is because the biological
healing time does not decrease with arthroscopy, and therefore, in certain situations, although arthroscopy is
an advance, healing time would be the same as with open surgery.
While exciting, arthroscopic surgery cannot treat all problems in the joint. Arthritic conditions are not well
treated by arthroscopy. There are many different kinds of arthroscopic surgery for several different kinds of
problems. Not all arthroscopy for individuals is the same. It is therefore difficult to compare your operation to
your neighbor's or some athletes on television.
An example of the above is the difference between a knee arthroscopy, involving cartilage removal, or a
so-called lateral release. Both are arthroscopic operations done to the knee. From the outside appearance,
they are about the same. However, the arthroscopic lateral release, done for kneecap injuries, is a harder
procedure for the patient to go through, because it causes more swelling in the knee for a longer period of
time, and cannot be likened to a cartilage removal. Therefore, recovery will be different. It depends on what
your problem is.
A FEW WORDS ABOUT YOUR
JOINTS
KNEE: The knee is a very complex joint. There are several areas of focus within the knee.
A. Cartilage: There are two kinds of cartilage in the knee.
1. Articular Cartilage: This is a gliding surface that covers the end of the femur (thigh bone) and the top of the
tibia (leg bone). The surfaces are the same things as the gristle cap on the end of a chicken leg that
pops off when you cook it. Damage to the articular surfaces is termed arthritis.
2. Meniscal Cartilage or Meniscus: These are C-shaped structures present around the edges of the joint on
the inner and outer sides of your knee. When torn, they frequently cause your knee to pop or give way,
or will just hurt. These are the most frequently injured structures in the knee, and the most common
reason for arthroscopic surgery. A large percentage of damaged articular cartilages will not heal, and
need to be removed. The damaged area can be removed by arthroscopic surgery, through the puncture
holes. Certain tears of the cartilage can now be sewn together arthroscopically, requiring splinting for
one month, to allow the tissues to heal.
B. Ligaments: Ligaments are strong tissue bands which provide the stability of the joint. The most common
ligament injury seen arthroscopically is the anterior cruciate ligament rupture. Repair of this now can be
done through arthroscopically-assisted techniques. However, the long-term recovery time is no different
through an open procedure, time in rehab, time on crutches, or time until return to competition.
C. Alignment: Many people can develop a problem in which the kneecap is injured or does not stay properly
located on the knee. It can slide partially off or completely off the knee or have injury to the back surface
of the kneecap (patella). Re-alignment may be necessary. Arthroscopic lateral release may be all that is
required to realign the kneecap properly. In this operation the supporting ligaments on the lateral portion
of the knee are released, in order to relieve pressure of the kneecap against the femur in bent-knee
positions.
D. Synovium: This is the inner lining of the knee, and only occasionally will cause pain in your knee.
SHOULDER
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Arthroscopic shoulder surgery may now aid in:
dislocating, subluxing or unstable shoulders;
certain cartilage tears;
biceps tendon injuries;
subacromial impingement syndrome;
rotator cuff tears;
loose bodies.
Revised Sept 2011